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SPIKES Protocol (Standard)

Practice the foundational steps of delivering bad news to a patient's spouse in a controlled setting.

  1. 1
    Review Clinical Case
  2. 2
    Patient Encounter
  3. 3
    Self Evaluation(optional)
  4. 4
    Feedback

Review Clinical Case

1. Learning: What is SPIKES?

Purpose of this Scenario

This simulation is designed to help you practice the SPIKES protocol, a structured framework for delivering difficult news. Before reviewing your specific scenario, take a moment to refresh your knowledge with this short video.

2. Scenario Briefing

Your Objective

Your goal is to deliver difficult news to Susan by following the 6-step SPIKES protocol. This scenario is designed to help you master the sequence and phrasing of the protocol with a receptive, though worried, family member.

Patient Background

You are about to call Susan, a 52-year-old woman, to provide a critical update on her husband, John. She is at home, anxious and awaiting your call.

Crucial Information: Earlier, other medical staff told Susan that John was "responsive" after he was brought in. She is clinging to this as a source of hope.

Key Medical Facts

  • Event: John, 55, collapsed suddenly at home.
  • Initial Findings: Large ischemic stroke, but was responsive to voice/touch on arrival.
  • Deterioration: Stroke has expanded with significant brain swelling.
  • Current Status: Unresponsive in the ICU, extremely poor prognosis.

3. How to Interact

Starting the Simulation

Follow these steps to begin the role-playing exercise:

  1. When you have reviewed the learning material and briefing, press the Start Call button below.
  2. You will hear the phone ringing for a few seconds.
  3. When the ringing stops, the AI patient will answer, but will wait for you to speak. You must initiate the conversation by saying "Hello?" or a similar greeting.
  4. Once the call begins, this orientation panel will be replaced by a live transcript of your conversation.

Learning Objectives

Optional prep details

Learning Objectives loading

Optional Pre-Call Knowledge Check

Optional self-check before you start

Knowledge Check loading

Find a quiet spot with a good internet connection. Speak naturally — it’s fine to pause to think.

After completing this scenario, you will be able to:

  • Recall the six steps of the SPIKES protocol (Setting, Perception, Invitation, Knowledge, Emotions, Strategy/Summary).
  • Apply the SPIKES framework to structure a conversation about delivering bad news.
  • Identify the purpose of each step within the SPIKES protocol during a patient interaction.

According to the SPIKES protocol, what is the primary purpose of the 'S' (Setting up the interview) step?

What is the main goal of the 'P' (Perception) step in the SPIKES protocol?

In the 'I' (Invitation) step, why is it important to ask for permission before sharing detailed information?